Register now to:
- access free premium content from The Lancet and its specialty journals;
- comment on blogs and share your opinions;
- and stay in touch with the latest news from TLS.
Our guest blogger Hafsa Hanif describes some of the lessons she has learned in struggle and hardship working in an extraordinarily resource-limited setting in Pakistan.
The technological advancement and unraveling of the mysteries of the universe that the planet has witnessed over the past decades is an unquestionable testimony to the supreme marvel and brilliance of the human being. Contemporary man has risen to heights that would have been inconceivable to the medieval man. However, there is still a swarm of distressful realities in the world, which may also be attributable to the works of human beings. Rising food prices, climate change, wars and conflict have caused unprecedented insecurity in various parts of the world. Affordable and accessible food, water, clothing, education and health services are fundamental rights of every man, woman and child. Yet, in our world today there are more than a billion people deprived of one or more of these rights.
The Global Hunger Index reports that 969 million people live on less than US $ 1 a day, and that 923 million people go hungry everyday. Living in a third world country for more than five years, amidst a turbulent economic and political scenario, the harsh realities of life have persuaded me to reflect on human suffering. As a medical student undergoing training at a public hospital, I have the opportunity to interact and experience the suffering of patients from the poorest strata of society. In the in-patient pediatric department, there is a separate section dedicated to malnourished children; as an informal estimate, many of the children in the other sections are also malnourished, or at least not thriving. Do they even have the opportunity to thrive? Without food to fill their stomachs, money to earn a decent education, and toys to entertain themselves with? According to the present protocols, only severely malnourished children with complications are admitted. But is there really anything sustainable they gain from being admitted? They can not afford to buy the nutritional supplements they are prescribed. And even if they get better during their stay at the hospital, they will likely become malnourished again after they are discharged.
Access to decent, quality health care is a luxury for the people of rural areas, who comprise the majority of the inhabitants of the country. It is not uncommon for patients to literally travel hundreds of kilometers to the hospital we are trained in. Many patients therefore do not report at all, and prefer to bear the pain than to spend their much precious money on travel expenses. For others there is just more misery in life to be concerned about. Once, while I was walking through an aisle of the gynecology department the disfigured appearance of a middle aged woman grabbed my attention. There were innumerable nodules of varying sizes on her face and neck that had left her severely defaced. On enquiring, she told me that she had been living with these nodules on her entire body for 10 years, and had never consulted a doctor, or so she said. As she drew up her sleeves and her ‘shalwar’ to show me her arms and legs, I was astonished to see how disfiguring they were. She had not come to the hospital for herself this time either; she was an attendant of her daughter who was admitted to the department.
Hafsa Hanif is a fourth year medical student at Dow University of Health Sciences, Pakistan. She wad raised in Riyadh but has been living in Karachi for the past 5 years, amidst poverty, violence, and tumultuous political conditions. At medical school, she receives clinical training at a public hospital that caters to the poorest strata of society.